A comparative study of frontalis sling surgery for simple congenital ptosis: use of autogenous fascia lata compared with silicon rod

Background: Drooping of the upper eyelid is one of the most common complaints in oculoplastic practice. Ptosis causes cosmetic deformity that is apparent both to the patient and to others. Frontalis suspension is a commonly used surgery that is indicated in patients with severe ptosis with poor levator muscle function. Aim: To evaluate the result of frontalis sling surgery, autogenous fascia lata compared with silicon rod in virtue of amount of lid lag, lagophthalmos, cosmesis and recurrence. Method: It is a prospective, non-randomized, interventional study of patients having unilateral or bilateral moderate to severe ptosis with poor levator function. A total 94 eyes were operated for frontalis sling surgery with a single pentagon (Fox) technique. Two groups classified - 54 unilateral eyes with silicon rod and 40 bilateral eyes with autogenous fascia lata. Patients evaluated till 6 months. Results: The results were compared in terms of cosmetic and functional success. The silicon sling group showed reduction in lid lag and lagophthalmos, which was extremely significant. But cosmesis and recurrence rate was similar in both groups. Conclusion: Frontalis sling surgery with silicon rod can be the procedure of choice for severe unilateral or bilateral ptosis with similar cosmetic and functional outcomes.